Functional Medicine

Perimenopause and Progesterone

Why is my progesterone declining?

The age effect – Progesterone naturally decreases when the eggs in the ovaries become depleted.

The cortisol effect  – Emotional and physical stressors can cause a precipitous drop in progesterone. The more stressed you are and the more unresolved trauma you have, the more you’ll feel the symptoms of low progesterone. Oxidative stress from toxins, mycotoxins, heavy metals, destabilized blood sugar levels, lack of sleep, and gut issues also lower progesterone. What’s more, high cortisol can block the progesterone receptors. This means stress not only lower progesterone but it also blocks your body’s ability to listen to it. This is why stress has such a dramatic impact on your hormones.

The hard truth is that the more stressed you are the worse you are likely to feel during peri-menopause. While you don’t have control over the age-related progesterone drop, you do have control over the stress-related progesterone drop.

Signs of low progesterone:

  • Irritability
  • Increased anxiety
  • Frequent night-time waking
  • Increased evening appetite
  • Increased bloating during the luteal phase of your menstrual cycle
  • Worsening PMS
  • Night sweats
  • Lower stress tolerance
  • Increased fat deposition on your waist and back
  • Shorter or longer menstrual cycle

“Fixing your hormones” is not always easy because of how hormones and inflammation cross-talk with each other. Nonetheless, herbs and hormones can help particularly when accompanied by a diet rich in nutrients.

When someone is just starting to experience the symptoms of low progesterone, I’ll start with herbs and fatty acids – chaste tree berry, omega 3’s, and evening primrose oil. Magnesium, vitamin C, and a B complex are also important.

If the symptoms are severe or don’t resolve after this (most do) bio-identical progesterone may be needed. I am not a prescriber but I will refer my clients out for HRT.

HRT requires a detailed assessment of that particular person and a conversation about the possible side effects. HRT is not for everyone but the quality of life improvements may trump the downside.

Written for Instagram – January 2024